So I’m delighted to see milestone, of a sort, achieved… a major health IT consortia is tackling in interoperability, and leveraging workflow technology, AKA Business Process Management (BPM) at the core of its “marketecture”.

“Healthcare Services Platform Consortium, a group of providers, IT vendors, system integrators and venture-led firms dedicated to solving the industry-wide interoperability problem.”

Read HSPC Incorporates, Gears Up to Tackle Interoperability Problem and then take a tour of slides from their slide deck. Take a look at the marketecture layers in the above slide: workflow, process, business model…. Then, there’s the title: Seamless Service Orientation with BPM and SOA. SOA stands for Service-Oriented Architecture. Those are the building blocks. But what puts the building blocks together? What is the usability cement combining the bricks into seamless whole? Business Process Management!

Now closely examine the next slide. “Workflow SDK… Intercepts actions and events on the OS level… Monitors state of every application… Delivers a seamless in the workflow integration.” What we’re essentially talking about here, is, a retrofitting of workflow-oblivious health IT legacy applications with the more modern process-aware BPM technology. The reason actions and events are intercepted at the operation system level, is there’s a natural decomposition of here, between app and OS. The apps may be monolithic. The OS may be monolithic. But there’s a place, between app and OS, where communications between apps and OS can be captured. Language translation systems often use this same technique. An app sends “Hello” to an OS managed dialogue box. The “hello” is trapped between app and OS (which manages dialogue boxes) and substitutes “Hola”. It will be very interesting to see is this approach will work.

Now the following slide is the key, the key to combining two healthcare subdomains crying out to be reunited. On one hand we have the process improvement folks (quality improvement, Lean, 6 Sigma, etc.). On the other hand, processes are so mediated by software that they are essentially DICTATED by software. This is why doctors hate EHRs! The doctor’s workflow is different from the EHR’s workflow. But, unfortunately for the doc, it’s actually painfully EASIER to change the doctor’s workflow to fit frozen health IT workflow, than to change health IT workflow to fit the poor doc’s workflow. So many of our problems today, in the health IT industry, boil down to this unfortunate fact.

What is to be done? CHANGE THE FACTS. That is, change what economists call the Production Function, and the rest of us engineers, scientists, analysts, and programmers call “technology.” And, if we change workflow-oblivous health IT technology into process-aware health IT technology, we can achieve a virtuous cycle. The processes that process improvement folks are trying to improve are locked up in software. But that software is directed by representations of workflow that can be improved by users editing process definitions and, increasingly, automatically through machine learning (Think Google Now for Health IT).

Compare the previous slide, from the HSPC slide deck, with the virtuous cycle rounding from workflow and process design, though execution and monitoring, then through simulation and optimization, and finally back through design and implementation of improved workflows and processes, with the following slide from one of my webinars several years ago. In this webinar the topic was the advantage of adding BPM technology to an ECM (Enterprise Content Management) system: Enterprise Content Management & Business Process Management: A Healthcare Game Changer.

THEN compare both slides to this classic depiction of the BPM life cycle from its Wikipedia entry.

All three of the previous diagrams, from the HSPC slide deck, my own slide about BPM and ECM, and the BPM Wikipedia entry, emphasize the virtuous cycle of process improvement that current workflow-oblivious health IT makes very difficult. In fact, one definition of BPM is, the “process improvement process” (done on steroids, with the right software.

By the way, one of these days I’ll put the aforementioned webinar online, including recorded narration, on YouTube. In the mean time, check out my BPM & Case Management: Healthcare Needs You! YouTube video.

Glad to see BPM pressed into use to tackle healthcare workflow interoperability!

P.S. I’m very interested in which BPM platform they will go with…. I suspect it will be one which one of the consortium partners already uses…. which means it might be… or … …. Whoever’s BPM stack is adopted, that is an enormously strategically powerful position in which to arrive!

Ebola & EHR Workflow Engines, Editors & Visibility

Robot-In-My-Pocket

Charles Webster, MD, MSIE, MSIS

Bio: HIMSS14, HIMSS15, and HIMSS16 Social Media Ambassador! If you've got a healthcare workflow story, I want to tell it, blog it, tweet it, interview you, etc.
Chuck Webster, MD, MSIE, MSIS has degrees in Accountancy, Industrial Engineering, Intelligent Systems, and Medicine (from the University of Chicago). He's the ex-CMIO for a three-time HIMSS Davies Award-winning pediatric EHR. Dr. Webster currently services as CMIMO (Chief Medical Informatics Marketing Officer) for workflow technology in healthcare. Chuck also created Mr. RIMP (@MrRIMP) (Robot-In-My-Pocket) a Bluetooth-controlled wearable robot for pediatricians and child life specialists to entertain children. Dr. Webster designed the first undergraduate program in medical informatics, was a software architect in a hospital MIS department, and is a judge for the annual Workflow Management Coalition Awards for Excellence in BPM and Workflow and Awards for Case Management. Chuck is a ceaseless evangelist for process-aware technologies in healthcare, including workflow management systems, Business Process Management, and dynamic and adaptive case management. Dr. Webster tweets from @wareFLO, @HealthITdog, and @MrRIMP (though there is some debate about the last two). He maintains almost a half-a-million words and graphics on numerous websites, including EHR Workflow Management Systems (http://chuckwebster.com), Healthcare Business Process Management (http://HCBPM.com) and the People and Organizations improving Healthcare with Health Information Technology (http://EHRworkflow.com). Please join with Chuck to spread the message: Viva la workflow!